Inspection on 28/01/09 for Egerton House Residential Home

This inspection was carried out on 28th January 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Egerton House Residential Home 18/12/07

Egerton House Residential Home 16/01/07

Egerton House Residential Home 20/01/06

Egerton House Residential Home 28/06/05

Egerton House Residential Home 02/03/05

Egerton House Residential Home 13/10/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Egerton House Residential Home 113 Hill Top Lane Kimberworth Rotherham South Yorkshire S61 2ER     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ramchand Samachetty     Date: 2 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Egerton House Residential Home 113 Hill Top Lane Kimberworth Rotherham South Yorkshire S61 2ER 01709559643 01709559643 egertonhouse@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Parneet Virk,Mr Sarbjit Singh Virk Name of registered manager (if applicable) Miss Susan Lorraine Foster Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 21 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Egerton House is registered to provide care and accommodation for up to 21 older people. The home provides both long and short-term care for its client group. Mr and Mrs Virk are the registered provider. The home is situated in the Kimberworth area of Rotherham and is within easy reach of the town centre and other local amenities. Egerton House is a two-storey building, Care Homes for Older People Page 4 of 27 care home 21 Over 65 21 0 Brief description of the care home which has been extended to provide its current accommodation. There are 17 single and 2 double bedrooms. The communal areas consists of a dining room and two lounges. There is a small quiet room on the first floor for use by people living at the home and their relatives. Bathrooms and toilets are available on both floors. The kitchen and laundry are located on the ground floor. There is a call system in all rooms, which is available to all occupants. There is a passenger lift to facilitate access between the two floors. The Home has a garden and patio area and there is a car parking facility at the front of the building. The fees for care at the home at 28th January 2009 were £350.00 per resident per week. Items not covered by the fee include hairdressing and personal toiletries. There is a statement of purpose and service user guide. These documents give more information about the home and its facilities. Further information can be obtained from the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was carried out on 28 January 2009, starting at 9.30 and finished at 16.30 hours. The registered manager, Mrs Susan Foster was present throughout the inspection. The service is registered to provide care for up to 21 older people. There were only 13 people living at the home at the time of this inspection. All the key national minimum standards for Care Homes for Older People were assessed. The inspection included a tour of the premises, examination of care documents and other records, including those pertaining to complaints, staff recruitment and employment, staff rota, medicines management, maintenance of equipment and quality assurance methods. Care Homes for Older People Page 6 of 27 We checked some of the information contained in the Annual Quality assurance Assessment that was submitted to us before this inspection. We considered the views of people who were using the service and those of their relatives and staff who worked at the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. At the end of the inspection,we gave feedback about our initial findings to the manager. We would like to thank all the people living at the home, the relatives we met, the manager and her staff for their assistance with this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who sought to use the service had their needs appropriately assessed before moving to the home, which ensured that a service was only offered, if their needs could be met. Evidence: The care files of two people who had been recently admitted to the home were checked. They included care needs assessments which indentified their diverse personal, physical and social needs. The assessments also included aspects of religious and cultural preferences. Assessments of needs were carried out by placing social workers and by staff, before people were admitted to the home. This ensured that a service was only offered to people whose needs could be met. The home did not provide intermediate care services. Care Homes for Older People Page 11 of 27 Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who used the service and their relatives were satisfied with the care being provided. The health and personal care of people who lived at the home was appropriately planned and provided and this promoted their wellbeing. Evidence: People who lived at the home and their relatives told us that they were satisfied with the care and support that was provided. They said that staff were courteous and friendly and were committed to their work. Relatives felt that their loved ones were well looked after and they appreciated the homely atmosphere in which care was provided. People who lived at the home and who could express their views indicated that personal care was always provided to them in a diligent and private manner and therefore their dignity was respected respected at all times. During our visit, we also observed some good interactions between staff and people who lived at the home. We looked at the care plans of three people who lived at the home. The care plans were based on the assessment of their needs, risks and preferences. They outlined the actions that were required to make sure that the care needs of each person were Care Homes for Older People Page 13 of 27 Evidence: appropriately met. Risks faced by individuals were assessed and action to manage them were included in the care plans. We noted that the recording of care provided to individuals had been improved. Visits by health care professionals were well recorded, with appropriate outcomes and follow-up. The care records showed that staff were proactive in ensuring that people living at the home had appropriate access to community health services as required. The individual care plans that we checked indicated that they had been regularly reviewed. In one instance, a relative had attended and participated in the review. Staff explained that they would invite relatives to take part in care plan reviews and if they were not able to attend, they would discuss pertinent issues with them and note their views. We looked at the way medicines were managed at the home. We noted that the storage of medicines had been improved. The medicines trolley was kept away from the dining area and this gave more space for use by people who lived at the home. We checked a sample of medicines administration record (MAR) sheets. They were satisfactorily maintained. Medicines received at the home were appropriately recorded and stored. Medicines administered were appropriately signed for. None of the people living at the home were administering their own medicines. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home were able to benefit from their preferred style and level of social stimulation and this allowed for their social inclusion and helped to improve their quality of life. Evidence: During our visit, we observed people who lived at the home, spending time in lounges and in their own rooms, watching television, listening to music or talking to others. We noted that staff would talk to people in their care while carrying out care tasks and people said that this brightened their day. We noted that some care staff were spending time with individuals on a one to one basis, talking and listening to them. One relative told us that staff were very good at listening to my mum. She added that staff were patient and caring. She did not feel that people were rushed into anything that needed doing. Relatives told us that they were always welcomed at the home. They said that they felt the routines at the home were very flexible. Staff would take into account the personal preferences of their loved ones when organising their daily activities. They could be assisted to get up and retire to bed at times that suited them. They could also choose who they spend their time with. where people could not make their own decisions, Care Homes for Older People Page 15 of 27 Evidence: staff would work with relatives and the people concerned in order to reach decisions that were in their best interest. Relatives said that staff communicated well with them. We noted that where relatives were not able to visit reguarly, staff would promote family contact by assisting people who lived at the home to make a telephone call or to send a card by post. Two relatives told us that they were very satisfied with the support that staff were providing to their loved ones. Staff explained that both indoor and outdoor activities were held at the home. Records of activities showed that people living at the home had taken part in various social activities. These included their preferred cultural and faith activities. People who lived at the home and their relatives told us that the meals prepared and served at the home were always good and tasty. They said that the meals were home-made from fresh ingredients and this made them very good. People who lived at the home were given good menu choices for breakfast, lunch and dinner each day. We noted that staff had carried out nutritional needs assessments of people in their care and had catered for them. We observed staff helping a few people with eating their meals, in an unhurried and dignified manner. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were able to use existing policies and procedures to safeguard people who lived at the home and to respond to their views and concerns. People who used the service were appropriately protected from potential harm and abuse. Evidence: There was a complaint procedure in place and copies had been provided to people who lived at the home and to their relatives. People who used the service told us that they were aware of how to raise their concerns. They said that they would approach the home manager if they had any serious concern and they were confident that she would put things right. The home had received one complaint in the last twelve months before our visit. The owner had investigated it and had written to the complainant with her findings. However, there was no records at the home to evidence the outcome of the complaint. There was an adult protection policy and procedures to guide staff on the promotion of safety and welfare of people who used the service, from potential harm and abuse. Care staff had received training on safeguarding people. In discussion, staff showed an understanding of the local procedures used in dealing with adult safeguarding issues. There had been one case of adult safeguarding at the home, since the last inspection. It had been investigated by the local adult safeguarding team of the Rotherham Social Services Department and had been satisfactorily concluded. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who lived at the home and their relatives were satisfied with its standard of accommodation and the facilities, which they found safe, clean, pleasant and comfortable. This helped to maintain and promote the health and wellbeing of people who lived at the home. Evidence: We checked the premises in the company of the manager. The building comprised of two floors and a set of stairs and a passenger lift facilitated access between them. The communal areas included two lounges and a dining room and a small quiet room. Bedrooms, bathrooms and hygiene facilities were located on each floor. The kitchen and laundry were on the ground floor. The manager confirmed that a number of bedrooms had been decorated and doors renewed. A new floor had been laid in the kitchen and sections of the kitchen walls had been tiled. A new sink had also been installed. The communal areas were clean and tidy. There was no unpleasant odour in the home. The manager confirmed that the hot water supply had been improved to reach all bedrooms. We viewed a few bedrooms with the permission of people who occupied them. The rooms were clean, tidy and well decorated. A few people had brought in some memorabilia and were therefore able to personalise their bedrooms. People who lived at the home and their relatives told us that the home was pleasant and very Care Homes for Older People Page 19 of 27 Evidence: comfortable. We noted that the surrounding grounds were appropriately maintained for the time of the year. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Adequate and appropriately trained staff were employed to provide care and support to people who lived at the home. However, there was a shortfall in the way documents regarding the recruitment process were handled and this could affect decisions to employ staff. Evidence: At the time of this inspection, there were 13 people in residence at the home. Besides the registered manager, there were two carers on all day shifts. Two carers were scheduled to work at night. There were other support staff, which included a cook, domestic and a laundry worker. The manager stated that the care staffing level took into account the dependency level of people who lived at the home. We looked at the duty rota and it showed that appropriate levels of care staff were consistently deployed on duty. We noted that staff turnover was very low and this promoted consistency and continuity of care. Relatives told us that there were always staff around to give personal attention to their loved ones. they said that staff were very good at what they do. A few people who lived at the home and who could express their views, told us that they were well looked after. They said that they were always attended to, in a timely and unhurried fashion. We noted that a key worker system was in place and this helped in maintaining personal attention to each person at the home and also in maintaining Care Homes for Older People Page 21 of 27 Evidence: good communication with relatives. We looked at the files of two newly recruited members of staff. One was employed as a care worker and the other as a cook. Records for each of the staff member included a completed application form and two written references. The manager stated that disclosures (CRBs) had been obtained for both members of staff. However, these were not kept at the home. The files also showed that they had received appropriate induction and training to make sure they had the necessary skills to carry out their duties. The manager stated that care staff had been offered training on a number of topics in the last twelve months. Training records showed that training included food hygiene, moving and handling, adult safeguarding and tissue viability and pressure ulcer care. The manager also stated that fire safety lectures and drills were regularly carried out. In discussion, staff confirmed that they had received the training mentioned. We noted that 9 out of the 10 permanent care staff had achieved their National Vocational Qualifications (NVQ) level 2 in care. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate management arrangements were in place to ensure the proper day-to-day running of the home. This helped to maintain and promote the safety and wellbeing of people who lived and worked at the home. Evidence: The registered manager has experience of caring for older people in residential setting. she has a National Vocational Qualification level 4 in care and management. In discussion, relatives and staff told us that the home was well managed and the manager was very approachable. Staff stated that they felt well supported in their work and that they received regular supervision. They were satisfied with the training opportunities that they had. We checked a sample of staff files ad they included notes of supervision. The manager explained that she had use of a few quality monitoring tools to help improve the service. These included monthly audits of care plans, medicines records, health and safety measures and residents and relatives satisfaction surveys and Care Homes for Older People Page 23 of 27 Evidence: meetings. We noted that a relatives satisfaction survey had just been sent out and that the manager was awaiting a response. We checked a recent audit of medicines records and it was appropriately undertaken. The manager stated that the provider was also conducting appropriate monthly unannounced visits to the home. However, copies of recent reports regarding these visits were not available at the home. Staff told us that they had regular meetings and this helped them to work together as one team. The manager had submitted the homes Annual Quality Assessment to us prior to this inspection. It showed that all appliances, utilities and equipment used at the home were appropriately serviced and maintained. Risks assessments and health and safety measures, including infection control and fire precautions were in place and these helped to maintain the health and wellbeing of people who lived at the home. Arrangements were in place to support people living at the home with the management of their personal monies. These arrangements were appropriately recorded. All financial transactions carried out on behalf of people concerned were appropriately recorded, witnessed and signed for and receipts were kept. The manager confirmed that a sum of money was made available for people who needed it outside office hours. We noted that a regular audit of the account of each individual was carried out to ensure correct balances were maintained. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 18 Staff disclosures from the Criminal Records Bureau (CRB) must be made available, as required, for inspection by this Commission. This is to ensure the safety and welfare of people who use the service. 08/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 16 All records relating to the management of complaints should be kept at the home and made available for inspection as necessary. Copies of reports relating to the monthly unannounced visits to the home, by the registered provider, should be kept at the home and made available for inspection as necessary. 2 33 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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